Examining the long-term effects of COVID-19 on the umbilical cord

Year 2022, Volume: 5 Issue: 5, 1371 - 1377, 25.09.2022

Fatih Taş , Mehmet Yılmaz , Fikri Erdemci , Fırat Aşır , Engin Deveci

https://doi.org/10.32322/jhsm.1138691

Cited By: 1

Abstract

Introduction: It is known that COVID-19 in pregnancy causes some negative consequences. Although some studies have been conducted on the possible effects of COVID-19 seen in late pregnancy, its effects in the previous trimesters are not clearly known. This study aimed to examine the umbilical cords of pregnant women who did not have COVID-19 and those who had in the second and third trimesters, after delivery using histopathological and immunohistochemical methods.
Material and Method: The study included 27 pregnant women who had never had COVID-19 (n:9), who had had COVID-19 in the second trimester (n:9) and had had COVID-19 in the third trimester (n:9). After delivery, sections were taken from the umbilical cords of the pregnant women and examined with histopathological and immunohistochemical (VEGF and vimentin antibodies) methods. H-scores were determined for statistical analysis of immunohistochemical staining results. Group means were analyzed using the non-parametric Kruskal Wallis Test.
Results: In cases that had COVID-19 in the third trimester of pregnancy, histopathological findings were more significant than in the other groups. Hemorrhage, thinning of the tunica intima layer, and deterioration in its integrity were observed in the umbilical vascular structures of this group. VEGF and vimentin expression levels were higher in the third-trimester group than in the other groups.
Conclusion: The COVID-19 disease has both acute and long-term effects. The presence of histopathological and immunohistochemical findings in the umbilical cord during the third trimester of pregnancy supports this information. Moreover, the high levels of expression of VEGF and vimentin in the umbilical cords of pregnant women may contribute to the understanding of the pathogenesis of COVID-19 and the post-acute effects of these proteins.

Keywords

COVID-19, umbilical cord, VEGF, vimentin, long COVID

References

• Velavan TP, Meyer CG. The COVID‐19 epidemic. Trop Med Int Health 2020; 25: 278.
• Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA 2020; 324: 782-93.
• Jain U. Effect of COVID-19 on the Organs. Cureus 2020; 12: e9540.
• Suvvari TK, Kutikuppala LS, Tsagkaris C, Corriero AC, Kandi V. Post‐COVID‐19 complications: Multisystemic approach. J Med Virol 2021; 93: 6451-5.
• Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J infect 2020; 82: e9-10.
• Taş F, Erdemci F, Aşır F, Maraşlı M, Deveci E. Histopathological examination of the placenta after delivery in pregnant women with COVID-19. J Health Sci Med 2022; 5: 868-74.
• Gürbüz T, Gökmen O, Kaptan G, İnanlı E, Karadeniz SB, Söylemez NE, Söylemez İ. Investigating anxiety, depression and obsessive-compulsive disorders among the pregnant women during Covid-19 pandemic. J Health Sci Med 2021; 4: 7-12.
• Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet 2020; 395: 809-15.
• Küçük Ş. Placenta and Umbilical Cord Histopathologies in Pathologic Spesmen and Relationship Between Pregnancy. Selcuk Med J 2019; 35: 1-8.
• Tantbirojn P, Saleemuddin A, Sirois K, et al. Gross abnormalities of the umbilical cord: related placental histology and clinical significance. Placenta 2009; 30: 1083-8.
• Yoon BH, Romero R, Park JS, et al. The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis. Am J Obstet Gynecol 2000; 183: 1124-9.
• Mullany LC, Darmstadt GL, Katz J, et al. Risk factors for umbilical cord infection among newborns of southern Nepal. Am. J. Epidemiol 2007; 165: 203-11.
• Salvatore CM, Han JY, Acker KP, et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study. Lancet Child Adolesc. Health 2020; 4: 721-7.
• Yim HE, Bae IS, Yoo KH, et al. Genetic control of VEGF and TGF-β1 gene polymorphisms in childhood urinary tract infection and vesicoureteral reflux. Pediatr. Res 2007; 62: 183-7.
• Vural P. Fizyolojik ve Patolojik Anjiogenezde Vasküler Endotelyal Büyüme Faktörünün Rolü. Türk Klinik Biyokimya Derg 2018; 16: 53-62.
• Olaya-C M, Michael F, Fabian G, et al. Role of VEGF in the differential growth between the fetal and placental ends of the umbilical cord. J. Neonatal. Perinatal Med 2019; 12: 47-56.
• Kuruçay HN, Gümüşova S. Feline İnfeksiyöz Peritonitise Genel Bakış ve Antiviral Yaklaşımlar. Turk Vet J 2021; 3: 4-12.
• Ivaska J, Pallari HM, Nevo J, Eriksson JE. Novel functions of vimentin in cell adhesion, migration, and signaling. Exp Cell Res 2007; 313: 2050-62.
• Kadner A, Zund G, Maurus C, et al. Human umbilical cord cells for cardiovascular tissue engineering: a comparative study. Eur J Cardiothorac Surg 2004; 25: 635-41.
• Stefanovic S, Windsor M, Nagata KI, Inagaki M, Wileman T. Vimentin rearrangement during African swine fever virus infection involves retrograde transport along microtubules and phosphorylation of vimentin by calcium calmodulin kinase II. J Virol 2005; 79: 11766–75.
• Yang Z, Wang M, Zhu Z, Liu Y. Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. J Matern Fetal Neonatal Med 2022; 35: 1619-22.
• Motwani R, Deshmukh V, Kumar A, Kumari C, Raza K, Krishna H. Pathological involvement of placenta in COVID-19: a systematic review. Infez Med 2022; 30: 157.
• Nizyaeva NV, Lomova NA, Dolgopolova EL, et al. Detection of SARS-Cov-2 N-protein in Mesenchymal Cells of Umbilical Warton’s Jelly in Women with COVID-19. Biomed Chem Res Methods 2022; 5: e00165.
• Ciccocioppo R, Gibellini D, Astori G, et al. The immune modulatory effects of umbilical cord-derived mesenchymal stromal cells in severe COVID-19 pneumonia. Stem Cell Res Ther 2021; 12: 1-10.
• Rodriguez HC, Gupta M, Cavazos-Escobar E, El-Amin SF, Gupta A. Umbilical cord: an allogenic tissue for potential treatment of COVID-19. Hum Cell 2021; 34: 1-13.
• Irtegun S, Agacayak E, Deveci E. Preeklamptik ve normotansif plasentalarda VEGF ve Vimentin ekspresyon düzeylerinin immunohistokimya ve Western Blot yöntemleri ile incelenmesi. Dicle Med J 2016; 43: 400-5.
• Yan J, Wu X, Zhang Q. Relationship between vascular endothelial growth factor and microvessel density in placenta and placenta increta. Chin J Perinat Med 2016; 12: 608-13.
• Bhavina K, Radhika J, Pandian SS. VEGF and eNOS expression in umbilical cord from pregnancy complicated by hypertensive disorder with different severity. BioMed Res Int 2014; 1-6.
• Wang H, Wang Y, Li D, et al. VEGF inhibits the inflammation in spinal cord injury through activation of autophagy. Biochem Biophysic Res Commun 2015; 464: 453-8.
• Aktoz M, Altay H, Aslanger E, et al. Türk Kardiyoloji Derneği uzlaşı raporu: COVID-19 pandemisi ve kardiyovasküler hastalıklar konusunda bilinmesi gerekenler. Turk Kardiyol Dern Ars 2020; 48: 1-48.
• Hu B, Huang S, Yin L. The cytokine storm and COVID‐19. J. Med. Virol 2021; 93: 250-6.
• Yılmaz EPT, Topdağı YE, Aşkın, S. Comparison of Vimentin Levels Between Preeclamptic and Normotensive Pregnant Women. J Obstet Gynecol Neonatal 2020; 17: 610-4.